Effect of Training on Learning Outcomes

 

VISION 

The Effect of Saccadic Training on Early Reading Fluency.
Leong DF, Master CL, Messner LV, Pang Y, Smith C, Starling A. Clin Pediatr. 2014; May, doi: 10.1177/0009922814532520.                                
ABSTRACT
Background: Eye movements are necessary for the physical act of reading and have been shown to relate to underlying cognitive and visuoattentional processes during reading. The purpose of this study was to determine the effect of saccadic training using the King-Devick remediation software on reading fluency.
Methods: In this prospective, single-blinded, randomized, crossover trial, a cohort of elementary students received standardized reading fluency testing pre- and posttreatment. Treatment consisted of in-school training 20 minutes per day, 3 days per week for 6 weeks.
Results: The treatment group had significantly higher reading fluency scores after treatment (P < .001), and posttreatment scores were significantly higher than the control group (P < .005).
Conclusion: Saccadic training can significantly improve reading fluency. We hypothesize that this improvement in reading fluency is a result of rigorous practice of eye movements and shifting visuospatial attention, which are vital to the act of reading.

Dyslexia in a French-Spanish bilingual girl: behavioural and neural modulations following a visual attention span intervention.
Valdois S, Peyrin C, Lassus-Sangosse D, Lallier M, Demonet JF, Kandel S. Cortex, 2014, 53:120-45.
ABSTRACT
We report the case study of a French-Spanish bilingual dyslexic girl, MP, who exhibited a severe visual attention (VA) span deficit but preserved phonological skills. Behavioural investigation showed a severe reduction of reading speed for both single items (words and pseudo-words) and texts in the two languages. However, performance was more affected in French than in Spanish. MP was administered an intensive VA span intervention programme. Pre-post intervention comparison revealed a positive effect of intervention on her VA span abilities. The intervention further transferred to reading. It primarily resulted in faster identification of the regular and irregular words in French. The effect of intervention was rather modest in Spanish that only showed a tendency for faster word reading. Text reading improved in the two languages with a stronger effect in French but pseudo-word reading did not improve in either French or Spanish. The overall results suggest that VA span intervention may primarily enhance the fast global reading procedure, with stronger effects in French than in Spanish. MP underwent two fMRI sessions to explore her brain activations before and after VA span training. Prior to the intervention, fMRI assessment showed that the striate and extrastriate visual cortices alone were activated but none of the regions typically involved in VA span. Post-training fMRI revealed increased activation of the superior and inferior parietal cortices. Comparison of pre- and post-training activations revealed significant activation increase of the superior parietal lobes (BA 7) bilaterally. Thus, we show that a specific VA span intervention not only modulates reading performance but further results in increased brain activity within the superior parietal lobes known to housing VA span abilities. Furthermore, positive effects of VA span intervention on reading suggest that the ability to process multiple visual elements simultaneously is one cause of successful reading acquisition.

Magnocellular training improves visual word recognition.
Chouake T, Levy T, Javitt D, Lavidor M. Front Hum Neurosci. 2012; 6(14), doi: 10.3389/ fnhum.2012.00014 10.
ABSTRACT
Current research has shown that basic visual networks, such as the magnocellular system, may play a crucial role in reading deficits related to dyslexia. The current study explored the relationship between magnocellular activity and reading abilities; we examined the hypothesis that a repeated usage of the magnocellular stream may improve reading by strengthening crucial neural pathways. Visual training was conducted for five consecutive days using a motion detection task (magnocellular training) and a control task of pattern detection (parvocellular training). Reading abilities of skilled readers were measured before and after the training using a lexical decision task. It was found that low-grade visual training overall can improve speed of lexical decision, but there is some indication that magnocellular training may selectively relate to accuracy. This potential added benefit of accuracy is crucial, and indicates that magnocellular training may have an advantage to parvocellular or general visual training when it comes to reading. This result lends support to the role of basic visual systems in reading, and has potential implications for neurorehabilitation of reading-related deficits.

Saccade control in dyslexia: development, deficits, training and transfer to reading.   
Fischer B, Hartnegg K. Optom Vis Dev 2008, 39(4):196-205.
ABSTRACT
Background: Saccade control is a complex function of our brain and relies on the coordination of several subcortical, cortical, and functional areas. In the past it has been difficult to use data from saccade analysis as an additional diagnostic tool for insight into any particular patient’s oculo-visual problem. With the development of technological advances and optomotor research there is now a better understanding of visually guided saccadic reactions. This article describes the development of saccade control, diagnostic data from dyslexic subjects, and the effect of daily saccadic and fixation practice and its transfer to reading skills.
Methods: All subjects were recruited from local schools. Several standard tests (reading, spelling, intelligence) were used for inclusion/exclusion of the subjects participating in the various studies. Eye movements were recorded by infrared light reflection methods. Prosaccades with overlap conditions and antisaccades with gap conditions were required in 200 trials for each task. Variables characterizing pro- and antisaccade performance were extracted for each subject. Mean values and standard deviations comparing the experimental and control subjects were calculated in each of the 4 age groups in an age range of 7 to 17 years. ANOVAs or t-test were used for statistical evaluations.
Results: The data from 114 normal control subjects show a developmental progression lasting until adult age. Among the 3230 subjects in the dyslexic group 20 to 70% (depending on age) failed the criterion of the age matched controls when looking at anti-saccade performance. Pro-saccade performance did not differentiate between the groups. Daily practice conducted by 182 dyslexic subjects improved their antisaccade performance in approximately 80% of the cases. For training subjects, it was noted that successful training transferred to the act of reading by reducing the percentage of reading errors in the experimental group (N=10) by 50% and by 20% for the control group (N=11).
Conclusion: This study suggests that deficits in anti-saccade control but not in prosaccade control contribute systematically to the problems of subjects with specific deficits in acquiring reading skills and that appropriate training can reduce the percentage of reading errors.

Effects of daily practice on subitizing, visual counting and basic arithmetic skills.
Fischer B, Kongeter A, Hartnegg K. Optom Vis Dev 2008, 39(1):30-34.     
ABSTRACT
Background: The ability of subitizing and counting undergoes a long lasting development until the age of 17 years. Large proportions of children with problems in acquiring basic arithmetic skills exhibit developmental deficits in the correctness and speed of this special visual capacity. The first study described in this paper tests the possibility that subitizing and visual counting can be improved by daily practice. The second study described in this paper shows that basic arithmetic skill were significantly improved in a trained as compared to an untrained control group.
Methods: Altogether, 74 subjects (age 7 to 13 y) participated in the first study. They were given a special task for daily practice during a period of 21 days. Corresponding to the state of the subject under training the difficulty of the task was adapted. For the second study 21 children (aged 7.5 to 9 y), were recruited from a local school. All children had problems in basic mathematics and failed the test of subitizing. The training group (N=10) was given the required training, while the waiting group (N=11) had to wait. A standard test of basic mathematics (DEMAT) was used to measure basic arithmetic skills before and after the training.
Results: The analysis of the pre-post training data revealed that subitizing and counting were significantly improved in about 85% of the subjects: they reached the normal range of the control subjects (N=133) of the same age. The second study shows that basic arithmetic skills were significantly improved in a trained as compared to an untrained control group.                
Conclusion: Since the result of the second study of this paper shows a transfer from improvements in subitizing to improvements of basic arithmetic skills one may conclude that the basic visual capacity of subitizing and visual number counting contributes to the problem encountered by children with dyscalculia.

Adaptation of voluntary saccades, but not reflexive saccades, transfers to hand pointing movements.
Cotti J, Guillaume A, Alahyane N, Pelisson D, Vercher JL. Journal of Neurophysiology 2007, 98:602-612.         
ABSTRACT
Studying the transfer of visuomotor adaptation [training] from a given effector (e.g., the eye) to another (e.g., the hand) allows us to question whether sensorimotor processes influenced by adaptation are common to both effector control systems and thus to address the level where adaptation takes place. Previous studies have shown only very weak transfer of the amplitude adaptation of reactive saccades—i.e., produced automatically in response to the sudden appearance of visual targets—to hand pointing movements. Here we compared the amplitude of hand pointing movements recorded before and after adaptation of either reactive or voluntary saccades, produced either in a saccade sequence task or in a single saccade task. No transfer to hand pointing movements was found after adaptation of reactive saccades. In contrast, a substantial transfer to the hand was obtained following adaptation of voluntary saccades produced in sequence. Large amounts of transfer between the two saccade types were also found. These results demonstrate that the visuomotor processes influenced by saccadic adaptation depend on the type of saccades and that, in the case of voluntary saccades, they are shared by hand pointing movements. Implications for the neurophysiological substrates of the adaptation of reactive and voluntary saccades are discussed.

The case for the visual span as a sensory bottleneck in reading.       
Legge G, Cheung S, Yu D, Chung S, Lee H, Owens D. Journal of Vision 2007, 7(2): 9.         
ABSTRACT
The visual span for reading is the number of letters, arranged horizontally as in text, that can be recognized reliably without moving the eyes. The visual-span hypothesis states that the size of the visual span is an important factor that limits reading speed. From this hypothesis, we predict that changes in reading speed as a function of character size or contrast are determined by corresponding changes in the size of the visual span. We tested this prediction in two experiments in which we measured the size of the visual span and reading speed on groups of five subjects as a function of either character size or character contrast. We used a “trigram method” for characterizing the visual span as a profile of letter-recognition accuracy as a function of distance left and right of the midline (G. E. Legge, J. S. Mansfield, & S. T. L. Chung, 2001). The area under this profile was taken as an operational measure of the size of the visual span. Reading speed was measured with the Rapid Serial Visual Presentation (RSVP) method. We found that the size of the visual span and reading speed showed the same qualitative dependence on character size and contrast, reached maximum values at the same critical points, and exhibited high correlations at the level of individual subjects. Additional analysis of data from four studies provides evidence for an invariant relationship between the size of the visual span and RSVP reading speed; an increase in the visual span by one letter is associated with a 39% increase in reading speed. Our results confirm the visual-span hypothesis and provide a theoretical framework for understanding the impact of stimulus attributes, such as contrast and character size, on reading speed. Evidence for the visual span as a determinant of reading speed implies the existence of a bottom–up, sensory limitation on reading, distinct from attentional, motor, or linguistic influences.

Training Direction-Discrimination Sensitivity Remediates a Wide Spectrum of Reading Skills.
Lawton, T. Optom Vis Dev. 2007, 38(1):37-51.              
ABSTRACT
Background: This study investigated whether timing deficits in the motion pathways represent a core deficit in inefficient readers who are dyslexic.
Methods: Inefficient and efficient readers in grades 2 and 3 in four public elementary schools were studied. Component literacy skills were measured before and after training. In the training task of interest, participants judged the direction of motion (left vs. right) of a vertically oriented sinusoidal grating, surrounded by one of five different background frequencies. The threshold contrast for direction discrimination was measured.
Results: Direction discrimination improved the most for inefficient readers following training. Moreover, following training the time to complete the task decreased significantly, showing that the timing of direction discrimination improves, as does the gain. For inefficient readers, training on direction discrimination resulted in significant improvements in reading efficiency and fluency. Inefficient readers in control conditions showed minimal improvement. Conclusions: Significant improvements in reading performance were found following training on direction discrimination. This study provides evidence that timing deficits in inefficient readers represent a core deficit.

M-cell deficit and reading disability: a preliminary study of the effects of temporal vision-processing therapy.        
Solan HA, Shelley-Tremblay J, Hansen PC, Silverman ME, Larson S, Ficarra A. Optometry 2004, Oct;75(10): 640-50.      
ABSTRACT
Background: This study examines the following questions: In moderately disabled readers, will temporal vision-processing therapy procedures that benefit reading comprehension, visual attention, and oculomotor skills ameliorate M-cell processing deficits as measured with coherent motion threshold testing? And will the results show a corresponding improvement in oral reading and verbal skills?
Methods: A sample of 16 moderately disabled readers, evaluated in a study completed 6 months earlier, were retested with another form of the Gates-MacGinitie Reading Test. Each participant was additionally tested for coherent motion, oral reading, and word attack skills. During the succeeding 6 months, fifteen 45-minute therapy sessions were administered once a week (as the school schedule permitted). After completing 15 therapy sessions, the initial testing procedures were repeated.
Results: All four variables–namely, Gates-MacGinitie Reading Test, Coherent Motion Threshold Test, Gray Oral Reading Test, and Woodcock-Johnson Word Attack Test revealed significant improvements after temporal vision therapy. Half of the 16 participants improved 2 or more years in reading comprehension, compared to no significant mean difference following the 6-month “control period” before the onset of therapy.
Conclusion: This research supports the value of rendering temporal vision therapy to children identified as moderately reading disabled (RD). The diagnostic procedures and the dynamic therapeutic techniques discussed in this article have not been previously used for the specific purpose of ameliorating an M-cell deficit. Improved temporal visual-processing skills and enhanced visual motion discrimination appear to have a salutary effect on magnocellular processing and reading comprehension in RD children with M-cell deficits.

Letter-recognition and reading speed in peripheral vision benefit from perceptual learning.
Chung S, Legge G, Cheung S. Vision Research 2004, 44(7):695-709.
ABSTRACT
Visual-span profiles are plots of letter-recognition accuracy as a function of letter position left or right of the midline. Previously, we have shown that contraction of these profiles in peripheral vision can account for slow reading speed in peripheral vision. In this study, we asked two questions: (1) can we modify visual-span profiles through training on letter-recognition, and if so, (2) are these changes accompanied by changes in reading speed? Eighteen normally sighted observers were randomly assigned to one of three groups: training at 10° in the upper visual field, training at 10° in the lower visual field and a no-training control group. We compared observers’ characteristics of reading (maximum reading speed and critical print size) and visual-span profiles (peak amplitude and bits of information transmitted) before and after training, and at trained and untrained retinal locations (10° upper and lower visual fields). Reading speeds were measured for six print sizes at each retinal location, using the rapid serial visual presentation paradigm. Visual-span profiles were measured using a trigram letter-recognition task, for a letter size equivalent to 1.4× the critical print size for reading. Training consisted of the repeated measurement of 20 visual-span profiles (over four consecutive days) in either the upper or lower visual field. We also tracked the changes in performance in a sub-group of observers for up to three months following training. We found that the visual-span profiles can be expanded (bits of information transmitted increased by 6 bits) through training with a letter-recognition task, and that there is an accompanying increase (41%) in the maximum reading speed. These improvements transferred, to a large extent, from the trained to an untrained retinal location, and were retained, to a large extent, for at least three months following training. Our results are consistent with the view that the visual span is a bottleneck on reading speed, but a bottleneck that can be increased with practice.

Effect of Attention Therapy on Reading Comprehension.
Solan, H., Shelley-Tremblay, J., et al. Journal of Learning Disabilities 2003, 36(6): 556-563.
ABSTRACT
This study quantified the influence of visual attention therapy on the reading comprehension of Grade 6 children with moderate reading disabilities (RD) in the absence of specific reading remediation. Thirty students with below-average reading scores were identified using standardized reading comprehension tests. Fifteen children were placed randomly in the experimental group and 15 in the control group. The Attention Battery of the Cognitive Assessment System was administered to all participants. The experimental group received 12 one-hour sessions of individually monitored, computer-based attention therapy programs; the control group received no therapy during their 12-week period. Each group was retested on attention and reading comprehension measures. In order to stimulate selective and sustained visual attention, the vision therapy stressed various aspects of arousal, activation, and vigilance. At the completion of attention therapy, the mean standard attention and reading comprehension scores of the experimental group had improved significantly. The control group, however, showed no significant improvement in reading comprehension scores after 12 weeks. Although uncertainties still exist, this investigation supports the notion that visual attention is malleable that the attention therapy has significant effect on reading comprehension in this often neglected population.

The role of visuospatial attention in developmental dyslexia: evidence from a rehabilitation study.
Facoetti A, Lorusso M, Paganoni P, Umilta C, Mascetti G. Cognitive Brain Research 2003, 15(2):154-164.
ABSTRACT
Shifting of visual attention induced by peripheral cues was studied in 24 children with specific reading disorder (SRD) or dyslexia and was compared with that of 19 normal readers by means of a covert orienting paradigm. This paradigm presents participants with valid, neutral and invalid spatial cues preceding the presentation of a target stimulus. As compared to normal readers, in SRD children the inhibition effect (i.e. the difference between neutral and invalid cues) was absent. The 24 SRD children were divided into two groups matched for age, IQ and reading ability to study the efficacy of two different rehabilitation procedures. We assessed the effects on reading accuracy and speed over a 4-month treatment with visual hemisphere specific stimulation (VHSS; J. Learn Disabil. 25 (1992) 102) vs. traditional speech training. The VHSS program trains participants to perform rapid endogenous attentional orienting by presenting briefly flashed words in the peripheral visual field. We found that children treated with VHSS showed significant changes in their attentional inhibition process, as indicated by increased costs for ‘reorienting’ the attentional focus. As this treatment program also proved to be highly efficient in improving the children’s reading abilities, the possible causal relationship between reading and inhibition mechanisms of visuospatial attention was discussed.

Learning-related visual problems in Baltimore City: A Long-Term Program.
Harris P. Journal of Optometric Vision Development 2002, 33(2): 75-115.
ABSTRACT
A longitudinal, single-masked, random sample study of children at a Baltimore City Public Elementary school documents the prevalence of learning-related visual problems in the inner city of Baltimore and tests the effectiveness of vision therapy. Vision therapy was provided to one of the randomly selected groups and data were collected on optometric tests, visual performance tests, and standardized achievement tests before and after treatment was provided. Data presented show that the vision therapy program has made a significant difference in the demand level of reading that could be read for understanding, in math achievement on standardized testing, and in reading scores on standardized testing, as well as on infrared eye-movement Visagraph recordings, which show significant changes on nearly all mechanical aspects of the reading process.

Role of visual attention in cognitive control of oculomotor readiness in students with reading disabilities.
Solan H, Larson S, Shelley-Tremblay J, Ficarra A, Silverman M.  Journal of Learning Disabilities 2001, 34 (2): 107-118. 
ABSTRACT
This study investigated eye movement and comprehension therapy in Grade 6 children with reading disabilities (RD). Both order of therapy and type of therapy were examined. Furthermore, the implications of visual attention in ameliorating reading disability are discussed. Thirty-one students with RD were identified using standardized reading comprehension tests. Eye movements were analyzed objectively using an infared recording device. Reading scores of participating children were 0.5 to 1 SD below the national mean. Testing took place before the start of therapy (T1) and was repeated after 12 weeks (T2) and 24 weeks (T3) of 13 therapy. One group of students had eye movement therapy first, followed by comprehension therapy; in the other group, the order was reversed. Data were evaluated using a repeated measures MANOVA and post hoc tests. At T1, mean reading grade was 2 years below grade level, and eye movement scores were at about Grade 2 level. Mean growth in reading comprehension for the total sample was 2.6 years at T3: equally significant improvement was measured in eye movements. Learning rate in reading comprehension improved from 60% (T1) to 400% (t3). Although within group differences were statistically significant at T2 and T3. Eye movement therapy improved eye movements and also resulted in significant gains in reading comprehension. Comprehension therapy likewise produced improvement both in eye movement efficiency and in reading comprehension. The results support the notion of a cognitive link among visual attention, oculomotor readiness, and reading comprehension.

A comparison of auditory/ language therapy with school visual support procedures in a public school setting.
McKane F, et al. Journal of Optometric Vision Development 32 (2): 83-92, 2001.
ABSTRACT
Some hold that poor reading eye movements are caused by poor language skills and if the auditory/ language skills were improved that reading and eye movements during reading would also improve. Twenty-nine third grade children who had previously been identified as being below average in some academic area were the subjects of this study. The experimental group contained 18 subjects, equally distributed between genders. After screening evaluations, all children were enrolled in an auditory/language enrichment program and the experimental group also received school based vision techniques which were individually programmed and administered by school personnel, in the school setting daily for 30 minutes a day for 3.5 months. Both groups improved significantly over pre-test scores on the reading aspect of the WRAT and reading rate with comprehension as measured by the Visagraph. The experimental group also demonstrated a significant improvement in reading eye movements as measured by the Visagraph, but the control group did not. The authors concluded that both visual and auditory/language intervention has a positive effect on the reading WRAT scores as well as the reading rate with comprehension. Reading eye movements, however, were significantly improved.

Vision problems of children in poverty in an urban school clinic: Their epidemic numbers, impact on learning, and approaches to remediation.
Orfield A, Basa F, Yun J. Journal of Optometric Vision Development 2001, 32 (3): 114- 141.
ABSTRACT
The Mather School pilot study explores the relationship between vision and learning by analyzing clinical vision data gathered in an urban school eye clinic from fall 1993 to spring 1999, and relating the vision findings with available standardized test scores and teacher grades. There were 1544 vision evaluations on 801 students, 226 extended functional vision exams on students who failed the initial evaluation, 79 children who received some vision therapy and 116 who received glasses, mostly for close work, and another 85 who received prescription for glasses. Our in-school evaluations found a higher incidence of vision problems than reported in previous studied. Without counting the visual tracking test, 41% failed: adding the tracking test, 53% failed. The majority of the vision problems we found were related to near vision, including a great deal of hyperopia, and were associated with lower average test scores. Our treatments of reading glasses and vision therapy improved visual function on specific tests, with those who had the poorest findings on individual measures improving the most. Correlated with these treatments are improvements in teacher grades, percentiles, and grade equivalents on standardized tests in reading and mathematics. Even with our limited study, the data suggests that there is a high incidence of these problems, that some of these problems are correlated with lower scores in reading and math, that they can be treated in a school setting, that school screenings should be expanded to include more near point tests, that detailed functional vision exams should be required of all children falling behind in school, and that The Developmental Eye Movement test, which 24.5% of the children failed, is an excellent predictor of a significant percent of reading failure risk and should be administered to all school children in the early grades so that help can be given early. Remediation for poor visual skills is as important as remediation for learning failure, because lack of many of these skills correlate with learning problems.

Monocular occlusion can improve binocular control and reading in dyslexics.
Stein JF, Richardson AJ, Fowler MS. Brain. 2000, 123(1):164-70.  
ABSTRACT
Developmental dyslexia is a neurodevelopmental condition which causes 5-10% of children to have unexpected difficulty learning to read. Many dyslexics have impaired development of the magnocellular component of the visual system, which is important for timing visual events and controlling eye movements. Poor control of eye movement may lead to unstable binocular fixation, and hence unsteady vision; this could explain why many dyslexics report that letters appear to move around, causing visual confusion. Previous research has suggested that such binocular confusion can be permanently alleviated by temporarily occluding one eye. The aim of the present study was therefore to assess the binocular control and reading progress of dyslexic children with initially unstable binocular control after the left eye was patched. One hundred and forty-three dyslexics were studied. They were selected from children aged 7-11 years referred to a learning disabilities clinic if they were dyslexic and had unstable binocular control. They were randomly assigned to wear yellow spectacles with or without the left lens occluded, and were followed for 9 months. Significantly more of the children who were given occlusion gained stable binocular fixation in the first 3 months (59%) compared with children given the unoccluded glasses (36%). This advantage was independent of IQ or initial reading ability. Furthermore, at all the 3- month follow-ups, children were more likely to have gained stable binocular control if they had been wearing the occluded glasses. Gaining stable binocular control significantly improved reading. The children who did so with the help of occlusion improved their reading by 9.4 months in the first 3 months, compared with 3.9 months in those who were not patched and did not gain stable fixation. Over the whole 9 months, children who received occlusion and gained stable fixation nearly doubled their rate of progress in reading compared with those who remained unstable. At all the follow-ups the reading of those given occlusion was significantly better than that of those not occluded. Thus monocular occlusion helped children with unstable binocular control to gain good binocular fixation. If they gained stability, they made significantly faster reading progress. The progress made by the children who gained stable fixation was much greater than that achieved with other remedial techniques.

Outcome of treatment of visual problems in children with reading difficulties. Learning Difficulties Clinic, Royal Berks Hospital, Reading & University Laboratory of Physiology, Oxford.
Clisby C, Fowler MS, Hebb GS, Walters J, Southcott P, Stein JF. Professional Association of Teachers in Special Situations (PATOSS), Bulletin Nov.2000, 9-14.  
ABSTRACT
These results show that our treatments helped children with reading problems very considerably; their rate of increase in reading age tripled compared with what would have happened had they not been treated at all. This compares very favourably with much more time consuming and costly remediation programmes such as those described by Hornsby and Miles (1980) and Thomson (1993) after which reading improvements of 1.8 – 1.9 months per month were seen. Monocular occlusion, vergence fixation and pursuit tracking exercises are effective because they help these children to improve slight defects in their control of the two eyes when they are trying to fixate on the text. Long wavelength (red, yellow and green) filters probably help because they enhance input to the magnocellular system which plays a major role in ocular motor control, at the expense of the parvocellular system which is normally in competition with the magno system. We speculate that blue filters cutting out long wavelengths may help some children because they have abnormally large numbers of blue cones that are depressed by long wavelength light. We are actively researching these ideas at present.

A randomized prospective masked and matched comparative study of orthoptic treatment versus conventional reading tutoring treatment for reading disabilities in 62 Children.
Atzmon D, Nemet P, Ishay A, Karni E. Binocular Vision and Eye Muscle Surgery Quarterly 1993, 8 (2): 91-106.
ABSTRACT
Schools need better and economical methods of treating reading disabilities. Controversies remain whether orthoptics and/or “visual training” can remedy reading disabilities. Therefore, and to extend our prior studies, we undertook a comparative and controlled study. 120 children with reading disability were tested extensively, matched and randomly divided into three groups: orthoptic, conventional (reading tutoring) and no-treatment control. Unfortunately, participants in the control group were unable to adhere to no treatment and were deleted. Each of the 40 children in the first two groups had 40 sessions, 20 minutes daily. Orthoptic treatment was directed to markedly increase fusional convergence amplitudes for both near and distance to 60 The two treatments were also carefully matched in time and effort. Examination of subjects revealed that 100% had poor fusional convergence amplitudes by our standards and 60% had 20 or less: two-thirds had a normal near point of convergence of 5 cm or less; many had a subjective reading and asthenopic symptoms in the presence of fusional convergence amplitudes said to be normal by other authorities. Sixty-two children in 31 matched pairs completed the course of treatment and testing. The results were: equal and statistically significant (P<.05) marked improvement in reading performance in both treatment groups on essentially all tests. Orthoptic treatment, to increase convergence amplitudes to 60 is as effective as conventional in-school reading tutoring treatment of reading disabilities. An advantage of orthopic treatment was that subjective reading and asthenopic symptoms virtually disappeared after orthoptics. We recommend orthoptic treatment as: 1) an effective alternate primary treatment: 2) adjunctive treatment for those who do not respond well to standard treatment: and 3) as primary treatment in any case with asthenopic symptoms of/or convergence inadequacy.

Optometric vision therapy – results of a demonstration project with a learning disabled population.
Seiderman A.  Journal of American Optometric Association 1980, 51(5):489-492.  ABSTRACT
Thirty-six children attending a private school for learning disabled children were diagnosed as having visual and /or perceptual disorders. The experimental group received individual programming in visual and perceptual development at their appropriate developmental levels. The control group received instruction in physical education, art or music classes. Both groups received individualized reading assistance. Statistical analysis of the two year demonstration project, which included nine months of actual training, indicated that the experimental group made significant gains in reading as compared to the control group. The improvement in basic instructional level of The Informal Reading Inventory (Temple University), and the Word Reading and Paragraph Meaning subtests of the Stanford Achievement Tests, and the actual classroom reading levels were all statistically significant. The Informal Word Recognition Invention (Daniels) and the spelling subtest of the Stanford Achievement Tests showed a definite trend approaching statistical significance.

The Effect of a Supplemental Perceptual Training Program on Reading Achievement.
Halliwell, J., Solan, H., Exceptional Children 1972, 38: 613-22.
ABSTRACT
At the beginning of the first grade, 105 students designated as potential reading problems were divided into three groups of 35 children each: experimental I, which received supplementary perceptual training in addition to the regular reading program; experimental II, which received traditional supplementary reading instruction in addition to the regular reading program; and the control group, which received no supplementary instruction. The Metropolitan Achievement Test (MAT) was administered at the end of May. The statistical analysis of the data indicated that, of all the groups, only the experiment I total group and the experimental I boys read significantly better than the respective control groups on the reading subtest of the MAT.

AUDITORY

Effect of nonlinguistic auditory training on phonological and reading skills.         
Murphy CFB, Schochat E. Folia Phonoiatrica et Logopaedica, International Journal of Phoniatrics, Speech Therpy and Communication Pathology 2011, 63(3):147-153.     
ABSTRACT
Objective: To analyze the effect of nonverbal auditory training on reading and phonological awareness tasks in children with dyslexia and the effect of age in relation to post-training learning considering the ages from 7 to 14.
Methods: In experiment 1, one group with dyslexia (total = 12) was trained and compared with a group of untrained dyslexic subjects (total = 28). In experiment 2, the performance of the trained dyslexic group (total = 18) was compared at three different moments: 2 months before, at the beginning, and at the end of training. Training was carried out for 2 months using a computer program responsible for training discrimination skills. Results: The group receiving nonverbal auditory training demonstrated significant improvements (mainly for the group from 7 to 10 years old), not only in the nonverbal auditory skills trained (p < 0.001), but also in phonological awareness syllable tasks (synthesis, segmentation, manipulation and syllable transposition) in experiment 1 (p < 0.003), and phonemic tasks (p < 0.001) and text reading (p < 0.001) in experiment 2.
Conclusion: The results suggest a link between verbal and nonverbal skills, in addition to corroborating studies regarding the existence of a critical learning period.

Neural correlates of rapid auditory processing are disrupted in children with developmental dyslexia and ameliorated with training: An fMRI study.
Gaab N, Gabrieli JDE, Deutsch GK, Tallal P, Temple E. Restorative Neurology and Neuroscience 2007, 25(3-4):295-310.
ABSTRACT
Purpose: Developmental dyslexia, characterized by unexpected difficulty in reading, may involve a fundamental deficit in processing rapid acoustic stimuli. Using functional magnetic resonance imaging (fMRI) we previously reported that adults with developmental dyslexia have a disruption in neural response to rapid acoustic stimuli in left prefrontal cortex. Here we examined the neural correlates of rapid auditory processing in children.
Methods: Whole-brain fMRI was performed on twenty-two children with developmental dyslexia and twenty-three typical-reading children while they listened to non-linguistic acoustic stimuli, with either rapid or slow transitions, designed to mimic the spectro-temporal structure of consonant-vowel-consonant speech syllables.
Results: Typical-reading children showed activation for rapid compared to slow transitions in left prefrontal cortex. Children with developmental dyslexia did not show any differential response in these regions to rapid versus slow transitions. After eight weeks of remediation focused primarily on rapid auditory processing, phonological and linguistic training the children with developmental dyslexia showed significant improvements in language and reading skills, and exhibited activation for rapid relative to slow transitions in left prefrontal cortex.
Conclusion: The presence of a disruption in the neural response to rapid stimuli in children with developmental dyslexia prior to remediation, coupled with significant improvement in language and reading scores and increased brain activation after remediation, gives further support to the importance of rapid auditory processing in reading development and disorders.

The effect of practice on low-level auditory discrimination, phonological skills, and spelling in dyslexia.      
Schaffler T, Sonntag J, Hartnegg K, Fischer B. Dyslexia 2004 (10):119-130.              ABSTRACT
Phonological awareness is believed to play a major role in the auditory contribution to spelling skills. The previous paper reports low-level auditory deficits in five different subdomains in 33–70% of the dyslexics. The first study of this paper reports the results of an attempt to improve low-level auditory skills by systematic daily practice of those tasks that had not been passed in previous diagnostic sessions. The data of 140 dyslexics indicate that the average number of unsolved tasks can be reduced from 3 of 5 to 1 of 5. The success rates have values of 70–80% for intensity and frequency discrimination and for gap detection, but reach only 36% for time-order judgement and 6% for side-order judgement. The second study reports that successful low-level auditory training transfers completely to language-related phonological skills and also to spelling with the largest profit in spelling errors due to poor auditory analysis. Control groups (waiting and placebo) did not exhibit significant improvements. It is concluded that low-level auditory deficits should be considered and improved by practice in order to give the dyslexics more phonological help when trying to transfer what they hear to spelling.

Neural plasticity following auditory training in children with learning problems.
Hayes EA, Warrier CM, Nicol TG, Zecker SG, Kraus N. Clinical Neurophysiology 2003 114(4):673-684.
ABSTRACT
Objective: This study examined the plasticity of the central auditory pathway and accompanying cognitive changes in children with learning problems. Methods: Children diagnosed with a learning disability and/or attention deficit disorder worked with commercial auditory processing training software for 8 weeks; control groups consisted of normal-learning and learning-impaired children who did not participate in any remedial programs. Auditory brainstem function was evaluated in response to click and speech stimuli in quiet; cortical responses to speech stimuli were obtained in quiet and noise. Academic achievement and cognitive abilities were assessed with standardized measures.
Results: Compared to controls, the trained group improved on measures of auditory processing and exhibited changes in cortical responses in quiet and in noise. In quiet, cortical responses reflected an accelerated maturational pattern; in background noise, cortical responses became more resistant to degradation. Brainstem responses did not change with training.
Conclusion: Children with learning problems who practiced with auditory training software exhibited plasticity of neural encoding of speech sounds at the cortical, but not subcortical, level of the auditory pathway. This plasticity was accompanied by improvement in behavioral performance.
Significance: This study demonstrates that in learning-impaired children working with commercial auditory processing training programs affects both the perception and the cortical representation of sound